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Relationship between arterial impedance and concentric remodeling in patients with normal systolic function: impact

Carl J Lavie1, Elise L Milani, Hector O Ventura

  • 1Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana 707121, USA. clavie@ochsner.org

Congestive Heart Failure (Greenwich, Conn.)
|November 23, 2011
PubMed

Insights

Concentric remodeling (CR) is common and linked to higher mortality. Lowering arterial impedance (IMP) in CR patients improves survival and structural recovery, suggesting IMP as a therapeutic target.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Clinical Medicine

Background:

  • Concentric remodeling (CR) is a known risk factor for morbidity and mortality.
  • The impact of arterial impedance (IMP) on survival in patients with CR remains poorly understood.

Purpose of the Study:

  • To assess the prevalence of CR in patients with normal systolic function.
  • To evaluate the combined impact of CR and arterial impedance (IMP) on patient survival.

Main Methods:

  • Analysis of 50,421 patients with normal systolic function.
  • Assessment of IMP's effect on mortality in 2,636 patients with paired echocardiograms, categorizing IMP as high (≥4.0) or low (<4.0).

Main Results:

  • CR was present in 21% of patients and associated with doubled mortality.
  • CR prevalence increased with higher IMP.
  • In the paired cohort, CR patients with low IMP had 6.3% mortality and 58% structural normalization, versus 10% mortality and 46% normalization for high IMP.

Conclusions:

  • Concentric remodeling is prevalent, linked to high mortality, and exacerbated by increased arterial impedance.
  • Reducing arterial impedance in CR patients is associated with improved survival and greater normalization of left ventricular structure.
  • Further research is needed to confirm the benefit of targeting IMP in CR management.

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